Evaluation of rational drug use knowledge level in patients with musculoskeletal disorders (original) (raw)
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Pharmacoepidemiology and Drug Safety, 2012
Purpose The use of prescription records for the assessment of exposure to nonsteroidal anti-inflammatory drugs (NSAIDs) does not capture over-the-counter drug use. This study compared patients' self-reported use to physician's prescriptions for NSAIDs and other drugs used to treat musculoskeletal disorders (MSDs). Methods The international Pharmacoepidemiologic General Research eXtension database includes a network of general practitioners recruiting patients without reference to diagnoses or prescriptions. Data on all drug use across France within the 2 years preceding the date of inclusion (index date) were obtained from both patients' self-reports (PSRs) and physicians' prescription reports (PPRs). Patients' reports were obtained using a structured telephone interview combined with an interview guide containing a list of drugs commonly used. Comparisons were made on exposure to four categories of MSD drugs and three time windows up to 24 months before the index date. Results Agreement between physician and patient reports was assessed on 4152 patient-physician pairs. Bias-and prevalence-adjusted kappa values showed fair agreement for nonaspirin NSAIDs, moderate to fair for nonnarcotic analgesics, high for osteoarthritis and moderate to substantial for muscle relaxants. Over-the-counter drug use was associated with greater disagreement (OR = 2.21, 95%CI = 1.05-1.38). Age was not associated with disagreement. Conclusion Differences between PSR and PPR in estimating the prevalence of MSD drug use varied by the type of drug and the elapsed time from the index date. The patient-assisted interview method used in this study showed better agreement with PPR compared with standard interviews, especially for long time windows and patients older than 65 years.
Correlation Of Knowledge Level With Pain Management In Elderly With Osteoarthritis
Jurnal Aisyah : Jurnal Ilmu Kesehatan, 2021
Background: Pain is the most common symptom felt by the elderly with osteoarthritis. Poor management of pain would impact their health status and quality of life in the end. Therefore, an adequate level of knowledge required to manage this pain properly. This study aimed to examine the correlation of knowledge level and pain management in the elderly population with osteoarthritis in WanaSraya Nursing Home. Method: . This study applied an analytic observational design with a cross-sectional approach to examine the correlation between the knowledge level and pain management in the elderly. Research participants that involved a total of 30 respondents selected by the total sampling technique.In this study using a questionnaire.Data analysis was carried out by using bivariate data analysis test using Pearson Correlation Test. Result: The study result showed that the majority of the respondent has a good level of knowledge related to osteoarthritis and pain management. Pearson Corr...
BMC Musculoskeletal Disorders, 2014
Background: Primary care pharmacological management of new musculoskeletal conditions is not consistent, despite guidelines which recommend prescribing basic analgesics before higher potency medications such as opioids or non-steroidal inflammatory drugs (NSAIDs). The objective was to describe pharmacological management of new musculoskeletal conditions and determine patient characteristics associated with type of medication prescribed. Methods: The study was set within a UK general practice database, the Consultations in Primary Care Archive (CiPCA). Patients aged 15 plus who had consulted for a musculoskeletal condition in 2006 but without a musculoskeletal consultation or analgesic prescription in the previous 12 months were identified from 12 general practices. Analgesic prescriptions within two weeks of first consultation were identified. The association of socio-demographic and clinical factors with receiving any analgesic prescription, and with strength of analgesic, were evaluated. Results: 3236 patients consulted for a new musculoskeletal problem. 42% received a prescribed pain medication at that time. Of these, 47% were prescribed an NSAID, 24% basic analgesics, 18% moderate strength analgesics, and 11% strong analgesics. Increasing age was associated with an analgesic prescription but reduced likelihood of a prescription of NSAIDs or strong analgesics. Those in less deprived areas were less likely than those in the most deprived areas to be prescribed analgesics (odds ratio 0.69; 95% CI 0.55, 0.86). Those without comorbidity were more likely to be prescribed NSAIDs (relative risk ratios (RRR) compared to basic analgesics 1.89; 95% CI 0.96, 3.73). Prescribing of stronger analgesics was related to prior history of analgesic medication (for example, moderate analgesics RRR 1.88; 95% CI 1.11, 3.10). Conclusion: Over half of patients were not prescribed analgesia for a new episode of a musculoskeletal condition, but those that were often received NSAIDs. Analgesic choice appears multifactorial, but associations with age, comorbidity, and prior medication history suggest partial use of guidelines.
BMC Musculoskeletal Disorders, 2009
Background: Many people attending rheumatology clinics use analgesics and non-steroidal antiinflammatories for persistent musculoskeletal pain. Guidelines for pain management recommend regular and pre-emptive use of analgesics to reduce the impact of pain. Clinical experience indicates that analgesics are often not used in this way. Studies exploring use of analgesics in arthritis have historically measured adherence to such medication. Here we examine patterns of analgesic use and their relationships to pain, self-efficacy and demographic factors.
Pain practice : the official journal of World Institute of Pain
The present study represents the next stage in the development of a psychometrically sound, self-report screening tool used for assessing the potential pain-medication-misuse risk. A revised Pain Medication Questionnaire (PMQ) was initially designed to successfully evaluate such risk. A subsequent series of two additional studies further documented the clinical utility of the PMQ. A new shortened version of the PMQ was developed, and its psychometric properties, along with its predictive accuracy in identifying risk for medication misuse, were evaluated. Results revealed that the new version maintained the strong psychometric properties of the original PMQ. Moreover, its predictive accuracy was found to be high (85.5% accuracy). Thus, this revised, shortened PMQ can aid physicians in assessing for potential medication misuse, allowing them to more closely monitor at-risk patients during pain management treatment.
European Journal of Pain, 2009
Research indicates that, despite physiotherapists' comprehensive training in the basic sciences, manipulative (currently «musculoskeletal») therapy is still dominated in the clinical setting by its original, now obsolete, structure-based «bio-medical» model. This is further inexplicable in the light of evidence that not only the underlying «philosophy» but also several of the fundamental requirements of the clinical process itself which has the structural-mechanical model as its basis, have been shown to be flawed or at least irrelevant. The apparent inability of the profession to fully abandon outmoded «concepts» (and embrace the acknowledged science-based «best practice» biopsychosocial model) may have potentially undesirable consequences for both patients and therapists engaged in the management of (chronic) musculoskeletal pain and disability.
The Journal of Rheumatology, 2021
ObjectiveWhile opioids are known to cause unintended adverse effects, they are being utilized by a number of patients with osteoarthritis (OA). The aim of this study was to evaluate the association of patient familiarity and perceptions regarding efficacy and risks with opioid medication use for OA.MethodsA total of 362 adults with knee and/or hip OA were surveyed in this cross-sectional study. Patients’ familiarity with and perceptions of benefits/risks of opioid medications were measured to evaluate potential associations with the utilization of opioid medications for OA within the last 6 months. Logistic regression models were adjusted for sociodemographic and clinical variables.ResultsIn this sample, 28.7% (100/349) reported use of an opioid medication for OA-related symptoms in the last 6 months. Those who were on an opioid medication, compared to those who were not, were younger (mean age 62.5 vs 64.8 yrs), were more likely to have a high school education or lower (48.0% vs 35...
Journal of Caring Sciences, 2017
Pain is the main reason for patients with osteoarthritis (OA) to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Methods: Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and outpatient clinics, and physicians' offices. Data saturation was reached after 31 in-depth and semi-structured interviews (five second interviews). Data were analyzed by qualitative content analysis, using comparison, reflection and interpretation techniques. The criteria used to enhance rigor included credibility, transferability, dependability, and confirmability. Results: Two main categories and six subcategories emerged from data analysis. The first main category included "adapting to the reality" which had three subcategories: Facing OA pain, seeking health care, and accepting pain as a part of life. The second main category included "behavior fluctuation" with three subcategory of role conflict, responsibility for self-care and, adherence to prescribed treatment versus selftreatment. Conclusion: Care seeking behaviors for chronic pain sufferers are void of cultural, emotional, social and financial situation and patient expectations. Some misconceptions emerged about the health problem and its management, which may lead to negative attitudes toward treatment and therapists and finally lead to nonadherence to treatment. Patients need for education to enhance appropriate health care utilization.
2010
Opioid analgesics are used routinely in managing acute musculoskeletal pain. However, physicians often hesitate to use them for chronic pain, such as that seen in rheumatoid arthritis, osteo- arthritis, osteoporosis, and low back pain. Starting the patient at a low dose and progressively titrating upward for pain relief minimizes the adverse effects. The fear that prescribing opioid analgesics for chronic pain will engender addiction is not supported by experience. Opioid analgesics are not first-line therapy for chronic pain; they should be used with other medications, such as nonopioid analgesics, anti-inflammatory drugs, muscle relaxants, antidepressants, anticon- vulsants, topical preparations, and sleeping pills. A comprehensive pa- tient assessment and an addiction history are essential. Consultation with a specialist in pain management often is helpful. (J Musculoskel Med. 2010;27:142-148)